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10 Actions for Responding to a Veteran in Crisis

Calls involving military vets require a different approach and tactics than other subjects.

January 24, 2013
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by Alison Lighthall

Photo: iStockPhoto.com

For more than a decade now, our country has been at war in two very different locations, with very different missions. In that time, more than 2.2 million troops have deployed and served in those bloody conflicts. They have endured unimaginable heat, bitter cold, and sand storms that peel the skin off your bones; they've missed births of children, weddings of friends, anniversaries of parents, and funerals of fallen brothers; they've witnessed the wholesale slaughter of innocents and savage acts of hatred and violence, as well as acts of such immense bravery, honor, and sacrifice as to change forever their version of courage.

But living through all that does something to you.

The civilian world often says with a bewildered shake of its collective heads, "We've lost so many young people during these wars." But in truth, only those who were there, or loved those who were there, have truly suffered the losses. Since only 1% of America puts on a military uniform, the rest of America has remained largely untouched. It is the 2.2 million who bear the greatest burden; most of them lost someone they knew, sometimes right before their eyes. It's also the 6,500 families who are devastated by the death of their loved one, who welcome home a flag-draped coffin, and who mourn in silence for years afterward.

Living through all that does something to you, too.

Tens of thousands of combat-weary warriors are now being discharged out of the military, often without a game plan as to what they will do next. Many of them entered the military right out of high school, so being a warrior is the only job they've ever had. And translating their specific skill set to civilian employment is tricky.

Now, after eight years of service, they take off the uniform that is their identity, turn in the weapon that they feel closer to than their own mother, leave behind a highly structured, mission-driven system with a clear chain of command, and enter into a world that looks utterly insane to them—a place where phenomenally popular "reality TV" is comic book dumb and bears no resemblance to the hard, cold reality they've lived.

Many of them are using their GI Bill and entering college, but are quickly learning that school is a different kind of battlefield, fraught with insensitive professors, clueless peers, and (thanks to getting their bell badly rung by an IED or two) new learning difficulties. Most are adapting, growing, and building new lives for themselves that make all of us proud. But some of them are really struggling.

Some don't know how to handle the disorienting re-entry, not to mention the bad memories that sometimes run in their heads like horror movies they can't turn off. So they drink, they drug, and they isolate themselves, partly because they are trying to achieve some inner quiet, and partly out of fear that one day they might completely lose control.

If that sad day comes, and the rage gets away from them, they usually rage against the people they love, often because even in their presence, the combat veteran feels misunderstood and very alone. Sometimes they aim their rage at themselves and put a 9mm in their mouths, wanting just to ease the crushing guilt they feel over having survived when their brothers didn't.

But either way, when a battle-hardened combat veteran is involved, these won't be your typical 911 calls. These guys are not only trained to kill, they're desensitized to the sights, sounds, and sensations of killing; the usual hesitation in pulling the trigger has been trained out of them. Imagine your SWAT team being called out twice a day for 365 days in a row. Tactically, that's the amount of experience you could be up against when you encounter a combat veteran.

These situations will require heightened awareness and additional skills to bring the incident to a positive resolution. The following are guidelines to help you navigate your way through the situation and reach the other side safely.

1. Look for clues that your subject is a veteran. Optimally, your dispatcher should routinely ask callers if they know whether the subject is a veteran. That will give you a leg up. The next obvious cues are things like dog tags, a military tattoo, combat uniform, desert boots, or a distinct military bearing. Also listen to what the subject says. Use of military words or phrases (e.g., "weapon" for gun, "squared away" for things being OK, "Groundhog's Day" for the sameness of every day, etc.) are hard to stop saying after eight years. If the situation allows you to actually talk with the subject, ask him directly, "Have you ever served in the military?" If yes, see if you can get any additional information from him without escalating him, such as which branch he served in, where he deployed to, and how long ago he got home. The more information you obtain, the more leverage you'll have to work with.

2. Once you've determined the subject is a combat veteran, take extra safety precautions. Most veterans I know carry a weapon on them all the time—usually a knife, sometimes a Ka-Bar. But some of them will also have a firearm in a gym bag or in their vehicle somewhere. Remember: their M4 was their guardian angel for many years. They feel tremendously vulnerable without something to replace it. If you've been called to a veteran's home for a fight, domestic situation, or suicidal gesture, assume there are weapons and ammo in the house.

3. When a veteran decompensates, the situation can become violent very quickly. If at all possible, establish some distance between the subject and everyone else around him. Phrases such as, "Hey, let's give him some breathing room, folks, give the guy some air," can clear some people away without insulting the veteran. This type of non-confrontational response will also decrease the veteran's sense of threat, which is crucial in helping the veteran to feel safe.

4. Keep in mind that the veteran's actions may be somewhat or completely out of his conscious control at that moment. He's probably in nine kinds of pain and probably hasn't gotten the help he deserves. So if it is at all appropriate and feasible, thank him for his service. Even if you have to take him down and handcuff him, try to be as respectful as possible. Do what you can to help the veteran save face. Obviously, in a foot chase, you're not stopping to make nice. If the guy is threatening you, you're not thanking him for his sacrifice. But if, for instance, it's a suicide gesture or the guy is in an argument with someone, thanking him changes the tone of the encounter and builds rapport, which is key to de-escalation and resolution.

5. Combat veterans can have some pretty dramatic responses to being startled. My advice: minimize the surprises. You can't control noises on the street or what other people do, but if, for instance, you need to pull out a pad and pen, don't just suddenly reach into your pocket—his warrior brain may kick in and think you're attacking him. Cue him into what you're doing by saying, "I'm just going to take some notes."

6. A corollary to that is to do things that will calm him. For instance, maintain an exterior that looks relaxed and confident. Use supportive language. Control your own voice; he'll sense anger or disgust in your tone, which he'll interpret as being disrespectful. If one of his kids is crying or his girlfriend is screaming at him, find a way of separating him from that. Neurologically, he's torqued up, and additional stressors like that can escalate things unnecessarily.

7. If you have any ties to the military yourself, or if your family member served in Iraq or Afghanistan, mention it. If you have any ties to New York City, tell him something like, "I personally appreciated you going over there and kicking the crap out of Bin Laden." The more real you can be with him, the less likely his subconscious is to view you as an enemy when it comes time for you to take action and the more likely he is to drop his defensive posture.

8. Let him talk, as long as it is helping him wind down. Validate how tough his situation is (whatever that may be). If he's ranting about something going on in his life, don't argue with him, just nod your head and say something non-committal like, "Yeah, that sounds like a tough situation." Time is your friend in these cases. Sometimes, the guy just needs to have a reason (jail) to regain control.

9. Think of the subject's behavior as symptoms of an injury, not as a mental illness. I've never understood how a soldier witnessing his best friend or battle buddy getting blown apart makes him disordered. Far more empowering (and accurate) is that the soldier has been injured by the experience. An injury requires some care and some time, maybe even some adjustments afterwards, but doesn't label the person as "broken." If you approach the subject with the understanding that he is injured vs. emotionally disturbed, he'll be far more likely to trust and connect with you.

10. If at any point the subject begins saying things that make no sense or are incongruous to the time and place, call the paramedics immediately and clear the area. If he starts shouting something like, "We're three clicks away and under fire!" or if he starts calling out names of people who are not present, he is most likely experiencing a flashback and is living out a memory. That means he's unpredictable. He may look straight at your uniform with the U.S. flag on it and, in his state, be absolutely convinced you are a suicide bomber about to detonate. He has no control over this behavior and cannot be "talked out of it," and attempting to do so may agitate him further. If he appears to be living out a battle scene, create as large of a perimeter for him as possible, let him know that the "medics" are on their way "to help with the wounded" and alert EMS to the situation when they arrive. And remember, be respectful. These are symptoms of a significant injury.

Given what they've been through, our veterans deserve our most profound compassion and assistance. Special veteran courts are being established nationwide and are allowing many veterans to receive clinical care instead of getting lost in the legal system. They can, and will, heal, if we as a nation become savvy enough to work toward giving them a leg up instead of a hand out.

Alison Lighthall, RN, BSN, MSN, is president of Hand2Hand Contact, a veteran-owned and operated training and consulting company that helps civilian organizations to better understand, work with, and care for veterans. She served as a captain in the Army Nurse Corps from 2004–2007, and is a member of the ILEETA trainers organization.

Comments (16)

Displaying 1 - 16 of 16

Jerry Rose Capt. LCSD @ 1/24/2013 6:01 PM

That was most disrespectful, and out of touch article, you have no idea what your talking about,US Vets have less % violence then same age group , I can't believe what I just read , by way I served 12 yr. US Army , 5th & 7th Special Forces Group. E7. Our vets deserves more respect .

SWAN @ 1/24/2013 8:40 PM

I sat in a briefing in 2008, a mandatory anti-suicide briefing, required before departing theater and was pissed off. Before it was over, the control group holding the session was forthright and confessed that statistically we were still below the norm when compared to our civilian counterparts. Yet, I see it continues to be an issue people like to talk about. Hyper-vigilance is going to be around for a long time, if it ever goes away. Feeling different than the guy/gal to your left/right is another unavoidable check the block hurdle. Giving them some space, talking to them, not through them, is a good place to start. Do not short change yourself as an LEO you have to make it home, but do not get "butterfly/puffy white cloud" nostalgic either. They know what authority is, they have seen field interviews and they have moved from house to house looking for bad people who do bad things. They have had to call "BS" when someone was smiling and lying as long as the day is long. Lay it out straight for them, be aware of your surroundings as stated above (potential red flags) and understand you can/should control the surroundings. Isolate from distracters (unruly significant others/the unappreciative civilian) and have a worthwhile dialog. Nothing they have seen or done is an excuse for poor behavior but it may be a good place to start coming back into the fold if they find themselves on the wrong side of the law and what you do may positively/negatively affect the outcome incrementally or exponentially.

Robert Cubby @ 1/25/2013 11:13 AM

I have to agree with Capt. Jerry Rose above.This article is so far off the mark. I suffered PTSD I know PTSD and the flashbacks and nightmares. No one I know with PTSD and none of the statistics support the contention of violence. Yes we are terrified and afraid. When those visions hit we are back there where we don't want to be. But to say we will explode with rage turned inward or outward is just so wrong. Our depression and our guilt is so overwhelming it prevents us from taking such a stand. Our depression and our guilt becomes so overwhelming and crushing that, if anything, we want to end it and the only way, for some is suicide. Your recommendations for response are sound but your attitude and the one you impart on first responders is faulty. They need a friend, a person who has been there and knows what they're going through. Not someone who diminishes their feelings but someone who validates how they feel. That's what they're yearning for. They're having trouble dealing with the flood of feelings they are experiencing. Letting them know it's OK to feel that way pays more dividends then trying to contain them in some articificial way. You were right when you said you cannot imagine losing a buddy in combat. So because you can't you have no idea how he feels about that one tragic moment frozen in time that to this day he cannot deal with. To say I'm disappointed in your article is an understatement.

Jeff LeClair @ 1/29/2013 3:23 PM

As an 8 year military police officer who spent four years in the 82nd Airborne as an infantryman before that I disagree with both of you. I have seen drunk soldiers who were having flashbacks and it helped to talk them down. This article is not meant to be derogatory but merely informative as to how LEO's should respond. Alot of this article is true and even you have to admit it. Whens the last time you saw a veteran without a firearm, knife or something they can use as a weapon. Every fellow soldier i know whether active or out has some form of something that can be used as a weapon. While you may find it offensive as someone who worked in this field I strongly concur that veterans cannot be treated like a normal call. For your sake I hope you never have to respond to a call where someone with PTSD is barricaded or combative. I mean Hooah for being SF but why don't you take a step back and look at it from a civilian standpoint?

Alison Lighthall @ 1/31/2013 5:23 AM

From the author: I take your comments seriously and appreciate your taking a few minutes to write. No where in the article do I say that this is how most, or even a large number, of veterans are going to respond. At no point do I say that combat vets are prone to violence. I wrote this based on several police organizations who have reached out to me because they've had incidents with veterans that they don't feel they handled well (i.e., wishing they could have de-escalated the situation in a way that kept the veteran out of the legal system all together), and based on the many hours of conversation I've had with vets in life-threatening crises.

The article's intent was to give LEOs who have no experience with veterans some ideas of how to best be respectful and supportive while still doing their job. That's why I emphasized that veterans suffering from post-traumatic stress are injured and not mentally ill, as so much of the media would lead you to think. (Thank you, "Swan" and Jeff LeClair, for backing me up on this.)

You are absolutely right that statistically we have lower rates of violence and suicide than the civilian population. I personally believe that's because we tend to be more internally disciplined and strive to be more respectful than most civilians today. This article was aimed at addressing only the small, but important, segment that unravel under the stress and require intervention. It was done from a place of utmost respect and compassion.

I hope this clarifies my true tone and purpose.

Dan Abreu @ 1/31/2013 11:38 AM

I train police officers to recognize manifestations of combat stress in veterans they encounter.If you want to see a real life example of what Allison is talking about check out the NPR story at this link: http://www.npr.org/2011/03/22/134657905/suicide-by-cop-leads-soldier-on-chase-of-his-lifeIncreasing police awareness about specific issues for veterans with combat stress can be a matter of life and death.I have a dozen headlines where there were fatal encounters between police and veterans. It's a serious issue.I do not read the article as stigmatizing veterans. I read it as raising awareness about veteran specific issues so that there are safe outcomes for veterans and police.

Fed Cop @ 1/31/2013 3:30 PM

Capt. Rose, I have to disagree with you. I deal with veterans every day, and I'm a LEO. I'm a Viet Nam Vet, with 24 years of active service. I've used some these techniques in dealing with angry veterans. You have to build the relationship with the vet so the situation doesn't escalate to the point of hands on. Our vets are suffering, and many still respect the uniform. But it's the brotherhood between the officers and the vet that can deescalate a situation. Knowledge on how to recognize what might have set the person off, and how react to the vet is a powerful tool. I'd rather calm the vet down, and get voluntary compliance than to have to practice my ground defense and recovery techniques becuase I didn't recognize the signal and now we're wrestling and I'm trying to stay alive.

Rescue7 @ 2/3/2013 9:08 PM

Good article. The same advice could be given for dealing with other people who lived through really stressful times or live in high crime environments. Defusing, de-escalating, and trying to bring calm to the situation is usually a good place to start in any call where one could be facing an armed and trained suspect. Or I guess you could charge in there and act like you own the place in which case you better have backup.I did 15 years in Recon and we had murders, suicides, and other serious crimes even without a war. Some people react poorly to the stress... Some NEVER get over it. All I've seen the VA and military medical personnel do is offer drugs to medicate symptoms. They don't put any real money into treatment.My deepest respects for 95% of the LEO out there... Just as in the military there is always that 5%. Probably best not to have them respond to a distressed PTSD vet call.

Dougherty @ 2/4/2013 12:11 PM

Well, everyone in general deals with situations differently. Veterans and non-veterans. Veterans are outstanding, brave, courageous people, who love the United States of America, which for the most cases, over the past 15 years is why they joined the military in the first place. Make no mistake these are great people.

Most police officers nationwide are also brave and courageous. So you put the two types of people who have alot of training together and you have a potential for a tragic situation. Police do not surrender, nor are they required to. Most do not have the training to recognize and deal with someone suffering severe PTSD. This article is a very good attempt to help them understand who they are dealing with, and how to help the veteran if at all possible, without tragic consequences.

Please keep the information coming.

Alison Lighthall @ 2/5/2013 7:34 AM

From the author: Great dialog. This is the kind of open communication we have to have with each other if we're going to find the "best practice" methods of intervening safely but compassionately with our veterans when they need us most.

lwhitt85 @ 3/9/2013 7:08 PM

This article is spot on for the new generation.

RJGJR @ 3/12/2013 8:25 PM

Interesting source article and responses from folks with cards in the game. I am not sure that 3 years as an Army Nurse places her in a position to propose recommendations to LE. I would strongly encourage LE to reach out to local Veterans Administration Medical Facilites as a resource. They have their own Federal LE Officers. The VA is spending considerable effort to understand the challenges facing our retuning Patriots. Comes from 38 years in the military LE/SWAT/Counter Intel, recently retired and along the way picked up a Medical Degree now employed as a VA Physician.

MadMax @ 3/13/2013 7:22 AM

As a vet, I really appreciate your article. Thanks

DaveSAM5525G @ 3/16/2013 1:05 AM

Sorry Longwinded by near and dear to heart! I respect everyone's feedback that's what makes America -America...what we need to find out is how some go through all this and manage it - I think alcohol and drugs are a key component that does not help as you are not getting to the root of the issue and that's how we all learn...be objective. Most people would be trusted and respected more is they said less and did more. Make no promises or commitments you have no intention of living up to…Its better here to say you will do your best unprecedented today but so simple! remember, Trust and Respect is earned through action(Consequence), not through promises (Antecedent). I understand that special operations –SF-Seal-PJ's -Ranger’s go through different training and that sharpens the mind and dealing with the stresses…We also have not been this long in WAR AOR. This article is very valuable and needed. I also believe this article is very well written and balanced it does take (listen and Learn)...

DaveSAM5525G @ 3/16/2013 1:07 AM

Part II-Nowhere in the article did it say not protect yourself rather items that show how to find common ground in the verbal judo realm. I know for a fact when everyone is yelling nobody is truly listening...And if you been in combat you know that yelling brings back allot of issues as that what you do to communicate over the bullets flying by, incoming - so even two or three people yelling may bring this back (hyper vigilance)...Awareness of actions what may trigger a bad reaction is vital situation awareness. I had to deal with my father's PTSD called it shell shock in the 60's and I was a kid...He was a Korean war vet and BAR rifleman who was up on pork chop hill and the punchbowl here in South Korea...Little to no help for vets in those days. Every time he drank we were the enemy the breaking point was when he tried stabbing my mother in front of us kids I was 7 years old, the knife went through her bathrobe and into the kitchen wooden door - off to grandmothers house again this time for long term stay until divorce final. Alison Light hall thank you for this article it is educational. It's sort of strange my father lost himself in South Korea and I have found myself here...I only wish I had the opportunity to tell my biological father I now understand - too late he passed in 1998...it took me many years to let go of the hurt – and pain I held towards him then as I did not understand it...I went to connect...I am retired now from military service and 8 years with DOD Federal Contractor Intel during 911- Chemical-Biological Sensor Systems (Portal-Shield). 25 years in South Korea to present...Above Stay Safe and God Bless!

Kat @ 10/10/2013 8:53 PM

To RJGJRRJGJR, she is the PERFECT position, as evidenced by her knowledge in the article. The VA police do not have the time nor the force to be educating EVERY civ police force. She is doing her part and stepping up. She gives straight forward, plain language, REAL WORLD information with the desire (clearly) to allow LEO to do their job, and to do it the right way. A way that won't end in unintended hurt for the Vet, the vets family, and the stress on the LEO themselves- their families, etc. Well done. I'm sharing this article .

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